title: Children often present with infantile spasms after herpetic encephalitis.
abstract: OBJECTIVE
  To determine what epilepsy types occur after herpetic encephalitis and what are the determinant factors for subsequent infantile spasms.
  
  
  METHODS
  We analyzed retrospectively the clinical history of 22 patients, referred to Necker and Saint Vincent de Paul Hospitals (Paris) through the French pediatric epilepsy network from March 1986 to April 2010 and who developed epilepsy some months after herpetic encephalitis. We focused on seizure semiology with video-electroencephalography (EEG) recording, and on neuroradiology and epilepsy follow-up.
  
  
  RESULTS
  Fourteen patients developed pharmacoresistant spasms, and eight developed focal epilepsy, but none had both. The patients who developed spasms were more frequently younger than 30 months at age of onset of epilepsy and had herpetic encephalitis earlier (mean 10.6 months of age) than those who developed focal epilepsy (mean 59.7 and 39.6 months, respectively). Epilepsy follow-up was similar in both groups (8.5 and 11 years, respectively). We found 26 affected cerebral areas; none alone was related to the development of epileptic spasms.
  
  
  CONCLUSIONS
  Risk factors to develop epileptic spasms were to have had herpetic encephalitis early (mean 10 months); to be significantly younger at onset of epilepsy (mean 22.1 months); and to have cerebral lesions involving the insula, the hippocampus, and the temporal pole.
authors.affiliation: Pediatric Neurology, Pediatric Department, Del Mar Hospital, Autonomous University of Barcelona, Barcelona, Spain. gaznar@parcdesalutmar.cat
authors.forename: Gemma
authors.initials: G
authors.lastname: Aznar Laín
authors.forename: Georges
authors.initials: G
authors.lastname: Dellatolas
authors.forename: Monika
authors.initials: M
authors.lastname: Eisermann
authors.forename: Nathalie
authors.initials: N
authors.lastname: Boddaert
authors.forename: Catherine
authors.initials: C
authors.lastname: Chiron
authors.forename: Christine
authors.initials: C
authors.lastname: Bulteau
authors.forename: José P
authors.initials: JP
authors.lastname: Monteiro
authors.forename: Isabelle
authors.initials: I
authors.lastname: An
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Pédespan
authors.forename: Claude
authors.initials: C
authors.lastname: Cancès
authors.forename: Sylvianne
authors.initials: S
authors.lastname: Peudenier
authors.forename: Marie-Anne
authors.initials: MA
authors.lastname: Barthez
authors.forename: Mathieu
authors.initials: M
authors.lastname: Milh
authors.forename: Georges
authors.initials: G
authors.lastname: Dorfmuller
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Héron
authors.forename: Rima
authors.initials: R
authors.lastname: Nabbout
authors.forename: David
authors.initials: D
authors.lastname: Grevent
authors.forename: Olivier
authors.initials: O
authors.lastname: Dulac
mesh_terms: D000367:Age Factors; D002540:Cerebral Cortex / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D020803:Encephalitis, Herpes Simplex / Q000150:complications / Q000378:metabolism*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012189:Retrospective Studies; D013036:Spasms, Infantile / Q000209:etiology / Q000378:metabolism*
keywords: Brain maturation; Herpetic encephalitis; Infantile spasms; Insula